PRE-QUALIFICATION APPLICATION RIGHT OF WAY ...

PRE-QUALIFICATION APPLICATION RIGHT OF WAY SERVICES FOR

GEORGIA DEPARTMENT OF TRANSPORTATION PROJECTS

Upon completing the application send the application and all required supporting documentation, as outlined for each discipline, to the email address specified in the section entitled Completed Application on page 13 below. Please note, the application will not be processed without all the supporting documentation attached.

Name of Applicant (Firm employees who are responsible for performing services on behalf of firm must submit separate applications.)

Main Telephone Number:

Firm Name (If you are employed by a firm, then provide the firm's legal name)

Fax Number:

Mobile Number:

Address:

Email Address: Federal Employer Tax Identification Number (EIN):

Check all Which apply: Sole Proprietorship Certified Individual DBE

Partnership Employed by DBE firm

Corporation

Types of Services Offered-This application is submitted to the Georgia Department of Transportation for consideration and for approval as a pre-qualified consultant for the particular types of service indicated below. Please see page 13 for instructions for completing the application.

Please mark below for either "New" or "Renewal" application.

A. Right of Way Services - Relocation

A-1 Conceptual Stage Study A-2 Relocation (Benefits Package Preparation) A-3 Relocation Benefits Package Reviewer A-4 Relocation Benefits Training Instructor

New New New New

Renewal Renewal Renewal Renewal

B. Right of Way - Pre/Post Project Prep

B-1 Plan Review B-4 Quit Claim Deed Preparation

New New

Renewal Renewal

C. Right of Way Services ? Valuation

C-1 Appraisal Report Level ______ (1, 2, 3, or 4) C-2 Appraisal Review Report C-3 Cost to Cure Report

New New New

Renewal Renewal Renewal

Ver 16_2022_09_15

Page 1

PRE-QUALIFICATION APPLICATION RIGHT OF WAY SERVICES FOR

GEORGIA DEPARTMENT OF TRANSPORTATION PROJECTS

C. Right of Way Services ? Valuation (continued)

C-4 Trade Fixture Report C-5 Sign Appraisal C-6 Environmental Assessment Report C-7 Septic Tank/Well Estimator C-8 Timber Report C-9 Detailed ROW Cost Estimator C-9-A Detailed ROW Cost Estimator for Negotiation C-10 Preliminary ROW Cost Estimator C-11 Concept Team Meetings

D. Right of Way Services ? Acquisition

New New New New New New New New New

Renewal Renewal Renewal Renewal Renewal Renewal Renewal Renewal Renewal

D-1 R/W Project Manager

New

Renewal

D-2 Pre- Acquisition Agent

New

Renewal

D-3 Acquisition Manager

New

Renewal

D-4-A Negotiation Agent Trainee *

New

Renewal

D-4-B Negotiation Agent 1 *

New

Renewal`

D-4-C Negotiation Agent 2 *

New

Renewal

D-4-D Negotiation Agent 3 *

New

Renewal

* Select only one box for D-4-A through D-4-D based on your level of qualifications.

D-5 Relocation Negotiation Agent

New

Renewal

D-6 Administrative Review Officer (Appeals)

New

Renewal

D-7 Interpreter (specify language _______________)

New

Renewal

D-8 District Acquisition Support Consultant

New

Renewal

D-9 ROW Training Instructor

New

Renewal

E. Right of Way Services - Property Management

E-1 Asbestos Inspection E-2 Asbestos Abatement E-3 Demolition E-4 UST Removal E-5 Site Inspector E-6 Surplus Property Disposal Agent E-7 Surplus Property Leasing Agent E-8 Surplus Property Management Project Manager

New New New New New New New New

Renewal Renewal Renewal Renewal Renewal Renewal Renewal Renewal

F. Right of Way Services - Court Coordination

F-1 Court Coordinator

New

Renewal

Ver 16_2022_09_15

Page 2

PRE-QUALIFICATION APPLICATION RIGHT OF WAY SERVICES FOR

GEORGIA DEPARTMENT OF TRANSPORTATION PROJECTS

LICENSING / ACCREDITATION -The applicant must be accredited and/or licensed for the service selected as described in the prequalification requirements section of this application.

This applicant is applying for basic prequalification services as indicated above for a period of three (3) years.

I understand that all services performed shall be in accordance with State of Georgia laws and regulations and as directed by the contract and authorized representative of the Georgia Department of Transportation (GDOT). I will only seek projects which I am qualified to perform and will not subcontract the work to other companies or individuals that are not approved by GDOT. Furthermore, if employed in this capacity, I agree to faithfully perform and abide by the contract terms and act in the best interest of GDOT. If GDOT should approve this application and determine I am eligible for service, I understand such approval and determination will not guarantee that I will be selected to perform any services on any project during this, or any other term. I understand that approval or tentative approval of this application will include me in a list of Pre-qualified Consultants, and that all Pre-qualified Consultants are subject to additional bidding or qualification procedures for actual selection. I further agree that if this application is approved, I will provide notice to GDOT of any changes to my affiliations, accreditations and/or certifications that would impact my eligibility.

I understand and agree that GDOT may release me from eligibility as deemed appropriate by GDOT at its sole discretion, and may change prequalification and/or selection processes at any time upon notice to eligible consultants.

Principal/Professional Name (Type or Print)

Principal/Professional Signature

Date

Sworn and subscribed before me this

day of

NOTARY PUBLIC My Commission Expires:

, 20_ . NOTARY SEAL

Ver 16_2022_09_15

Page 3

PRE-QUALIFICATION APPLICATION INSTRUCTIONS RIGHT OF WAY SERVICES

Purpose

The Department of Transportation's goal is to maintain and improve mobility by providing a safe, seamless, intermodal, environmentally sensitive transportation system. The Department seeks competent professionals to provide services to meet these objectives. Services which are ultimately procured through this prequalification application process play a major role in ensuring the quality of State of Georgia transportation projects.

To be eligible to perform specific Right of Way services on a GDOT project, consultants must be prequalified through this prequalification process. Such prequalification constitutes a GDOT determination of the consultant's basic eligibility and competence only. Additional qualifications submittals may be required for selection of certain services.

APPLICATION DELIVERABLES: APPLICANT PACKAGES SHALL BE 7 PAGES OR LESS (Per Service Type) AND BE PLACED IN THE FOLLOWING ORDER:

? Signed and notarized Application Form. ? Required documentation(see below).

Minimum Qualifications for Pre-qualification and Required Documentation (Note, the Required Documentation below, must be submitted tabbed or otherwise categorized in the same "alpha/numeric" order as the corresponding categories/headings below.)

The required experience and documentation are detailed below for each scope of service.

A. Right of Way Services ? Relocation A-1 Conceptual Stage Study:

? Documentation verifying a minimum of 5 (five) years' experience or supervision of this service at a government agency level in determining &/or administering Relocation Assistance Benefits in compliance with The Uniform Act, CFR 49, Part 24. This includes demonstrated ability, knowledge, and experience in preparing relocation benefits packages and studies of all types in accordance with FHWA regulations and policies (FHWA approved scope of relocation benefits packages and studies are kept on file with the Right of Way Relocation Office).

? Samples of at least 2 (two) conceptual stage studies, and the report for inclusion in the project's environmental document.

A-2 Relocation (Benefits Package Preparation): ? Documentation verifying a minimum of 5 (five) years' experience or supervision of this service at a government agency level in determining &/or administering Relocation Assistance Benefits in compliance with The Uniform Act, CFR 49, Part 24. This includes demonstrated ability, knowledge, and experience in preparing relocation benefits packages and studies of all types in accordance with FHWA regulations and policies (FHWA approved scope of relocation benefits packages and studies are kept on file with the Right of Way Relocation Office). ? Samples of at least 3 (three) relocation packages to be provided upon request (RES Owner, RES tenant, and Business).

A-3 Relocation Benefits Package Reviewer: ? Documentation verifying a minimum of 8 (eight) years' experience or supervision of preparing relocation benefits packages of all types. Must include experience on complex projects for Local, State or Federallyfunded roadway transportation projects. This includes demonstrated ability, knowledge, and experience in preparing relocation benefits packages and studies of all types in accordance with FHWA regulations and policies.

Ver 16_2022_09_15

Page 4

PRE-QUALIFICATION APPLICATION INSTRUCTIONS RIGHT OF WAY SERVICES

A-4 Relocation Benefits Training Instructor: ? Documentation verifying a minimum of 15 (fifteen) years' experience or supervision of preparing relocation benefits packages and claims of all types. Must include experience on complex projects for Local, State or Federally-funded roadway transportation projects. This includes demonstrated ability, knowledge, and experience in preparing relocation benefits packages and studies of all types in accordance with FHWA regulations and policies. ? Must have 5 (five) years formal training experience in related area.

B. Right of Way Services ? Pre/Post Project Prep B-1 Plan Review:

? Documentation verifying at least 5 (five) years' experience or supervision of this service at a government agency level as follows: o Proficient knowledge, demonstrated ability and experience in reading and drafting R/W Plans to include Right of Way / Easement Limits, Property Lines, Improvements, Parcel Identification Numbers, Dimensions, etc. o Must demonstrate knowledge and ability to review data tables and prepare complex legal descriptions and Quit Claim deeds.

? Must demonstrate ability to accurately review Right of Way plans if selected for an interview. ? Demonstrate knowledge of these services in accordance with State and Federal Regulations and any

additional guidelines and Departmental policies as it relates to Right of Way plan review checklist. B-4 Quit Claim DeedPreparation

? Documentation verifying at least 5 (five) years' experience or supervision of this service at a government agency level or completion of a GDOT facilitated training course as follows in Quit Claim Deed Preparation: o Proficient knowledge, demonstrated ability and experience in reading R/W Plans to include Right of Way / Easement Limits, Property Lines, Improvements, Parcel Identification Numbers, Dimensions, etc. o Must demonstrate knowledge and ability to review data tables and prepare complex legal descriptions and Quit Claim deeds.

? Must demonstrate ability to accurately prepare Quit Claim deeds and legal descriptions if selected for an interview.

? Must demonstrate ability to identify appropriate deed forms to attach to legal description per referenced plat for Quit Claim deed preparation.

? Demonstrate knowledge of these services in accordance with State and Federal Regulations and any additional guidelines and Departmental policies as it relates to Right of Way plan review checklist.

C. Right of Way Services - Valuation C-1 Level 1 Appraisal Report:

? Documentation of required State of GA Certified General Designation. (Registered, licensed, or certified residential designations are not approved classifications).

? Documentation verifying a minimum 2 (two) years eminent domain appraisal experience or supervision of this service at a government agency level or demonstration of ability to perform such work based on past experience.

? Completed 14 (fourteen) hours of eminent domain or condemnation appraising educational experience by an approved education provider by Georgia Real Estate Appraisers Board (GREAB).

? Documentation verifying past eminent domain appraisal experience as follows: o Actual appraisal report. o List of projects and level of participation.

Ver 16_2022_09_15

Page 5

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download